Elastic Compression Stockings for Prevention of Post-thrombotic Syndrome

NCT ID: NCT01578122

Last Updated: 2020-01-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-29

Study Completion Date

2019-06-28

Brief Summary

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Post thrombotic syndrome (PTS) is a frequent and burdensome complication of proximal deep-vein thrombosis.Therapeutic options for PTS are limited and mainly rely on its prevention. Therapeutic trials evidenced that elastic compression stockings (ECS) applying 30-40mmHg of pressure at the ankle reduced the rate of PTS by 50%. Although ECS are unlikely to cause harm, in clinical practice, compliance to this treatment appears to be low as ECS may be difficult to apply and to wear.

ECS with a lighter compression strength (20-30mmHg) might be easier to apply and be more comfortable. This could favor a better compliance.

CELEST is a randomized, multicentre, double-blind trial which aims to determine whether ECS applying 25mmHg of targeted pressure at the ankle are non inferior to ECS applying 35mmHg of targeted pressure at the ankle

Detailed Description

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CELEST trial is a controlled, randomized, multicentre, non-inferiority double-blind trial which aims to determine whether ECS applying 25mmHg of targeted pressure at the ankle are non inferior to ECS applying 35mmHg of targeted pressure at the ankle. Patients with a first acute symptomatic proximal DVT will be randomized to wear for two years either ECS applying 25mmHg of targeted pressure at the ankle or ECS applying 35mmHg of targeted pressure at the ankle. All patients will be prescribed anticoagulants for at least three months. The primary outcome will be the rate of PTS assessed with the Villalta scale in both arms of the study during the 2 years study period. Rate of compliance,severity of PTS and quality of life in both groups will constitute the main secondary outcomes.

Conditions

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Deep Vein Thrombosis Post-thrombotic Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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25mmHg ECS

Thigh-length graduated elastic compression stockings applying 25mmhg of targeted pressure at the ankle worn daily for two years

Group Type EXPERIMENTAL

25mmHg ECS

Intervention Type DEVICE

Thigh-length graduated elastic compression stockings applying 25 mmhg of targeted pressure at the ankle worn daily (from morning to night) for two years.

Before receiving the randomly allocated treatment, each patient will wear cotton, class III Varisma Comfort® stay-up stockings (20-36 mm Hg).

35mmHg ECS

Thigh-length graduated elastic compression stockings applying 35 mmhg of targeted pressure at the ankle worn daily for two years

Group Type ACTIVE_COMPARATOR

35 mmHg ECS

Intervention Type DEVICE

Thigh-length graduated elastic compression stockings applying 35mmhg of pressure at the ankle worn daily (from morning to night) for two years Before receiving the randomly allocated treatment, each patient will wear cotton, class III Varisma Comfort® stay-up stockings (20-36 mm Hg).

Interventions

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25mmHg ECS

Thigh-length graduated elastic compression stockings applying 25 mmhg of targeted pressure at the ankle worn daily (from morning to night) for two years.

Before receiving the randomly allocated treatment, each patient will wear cotton, class III Varisma Comfort® stay-up stockings (20-36 mm Hg).

Intervention Type DEVICE

35 mmHg ECS

Thigh-length graduated elastic compression stockings applying 35mmhg of pressure at the ankle worn daily (from morning to night) for two years Before receiving the randomly allocated treatment, each patient will wear cotton, class III Varisma Comfort® stay-up stockings (20-36 mm Hg).

Intervention Type DEVICE

Other Intervention Names

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ACTYS 25® for women LEGGER 25® for men ACTYS 35® for women LEGGER 35® for men

Eligibility Criteria

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Inclusion Criteria

* Patient (male/female) at least 18 years old
* Patient presenting with an initial episode of proximal deep vein thrombosis (DVT) confirmed by an additional examination (echo-Doppler scan) taken no more than 8 days previously :

the proximal character defined by a DVT from the collecting trunk extending from the tibial-peroneal trunk to the inferior vena cava inclusive the unilateral character concerns only the proximal part. Patients with a distal DVT on the contralateral member the day of diagnosis can be included The notion of initial episode concerns only the proximal part. Patients with a preceding DVT limited to distal part can be included

* with no trophic disorders at baseline (CEAP class 4, 5 or 6 excluded)
* with or without pulmonary embolism
* Patient capable of benefiting from anticoagulant therapy of at least 3 months duration
* Available to participate in a clinical trial with a 24-month follow-up period and for which a delivery of study products may be possible throughout its participation (delivery possible only in Metropolitan France)
* Life expectancy greater than 24 months
* Volunteer to take part in the study, having signed the consent form after receiving sufficient information and the information leaflet
* Person affiliated to social security or the recipient of a similar scheme.


* Patients with at least one of these contraindications to compression treatment:

* phlegmasia cerulea dolens,
* septic thrombosis,
* product intolerance, allergic reaction to one of the components
* Arteritis obliterans stage III and IV of the lower limbs (IPS\<0.6),
* Micro-angiopathy, advanced diabetes,
* Decompensated heart failure,
* Skin infections: anti-infective treatment must precede compression therapy,
* Weeping skin diseases of the leg.
* Compression treatment technically impossible during the study
* Patients presenting with bilateral venous thrombosis of the lower limbs.
* Patient having received fibrinolytic treatment, mechanical thrombo-aspiration or venous repermeation surgery for venous thrombosis justifying inclusion
* Patients having undergone mechanical interruption of the inferior vena cava.
* Patients for whom long-term elastic compression for the treatment of lymphatic venous insufficiency (patients with lymphoedema), for instance, is indicated prior to DVT. Patients with elastic compression for primary thromboprophylaxis of thromboembolic disease (TED) are eligible.
* Patients presenting with oedema unrelated to venous insufficiency or in whom oedema is likely to develop within 2 years.
* Patients receiving diuretic treatment for more than 3 months due to heart failure.
* Pregnant women
* Person deprived of liberty by a legal or administrative decision, person under legal protection.
* Patient currently participating in a clinical trial or having taken part in a clinical trial in the month preceding inclusion
* Patient presenting with a history of mental or psychiatric illness or any other factor restricting his/her ability to participate in an informed manner and in compliance with the protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Grenoble

OTHER

Sponsor Role collaborator

Floralis

INDUSTRY

Sponsor Role collaborator

Laboratoires Innothera

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Luc BOSSON, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

CIC Grenoble

Locations

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Cabinet

Lyon, Rhônes Alpes, France

Site Status

Cabinet

Aix-les-Bains, , France

Site Status

Cabinet

Alençon, , France

Site Status

Clinique Victor PAUCHET

Amiens, , France

Site Status

CHRU Amiens

Amiens, , France

Site Status

Cabinet

Amiens, , France

Site Status

Chu Angers

Angers, , France

Site Status

Cabinet

Annecy, , France

Site Status

Chra Annecy

Annecy, , France

Site Status

Centre Hospitalier d'Armentieres

Armentières, , France

Site Status

CH Armentières

Armentières, , France

Site Status

Cabinet

Bordeaux, , France

Site Status

Cabinet

Bourgoin, , France

Site Status

Ch Bourgoin-Jallieu

Bourgoin, , France

Site Status

Hia Brest

Brest, , France

Site Status

Chu Brest

Brest, , France

Site Status

CHU

Caen, , France

Site Status

Cabinet

Carcassonne, , France

Site Status

Cabinet

Chalon-sur-Saône, , France

Site Status

Ch Chalon Sur Saone

Chalon-sur-Saône, , France

Site Status

CH de Chambéry

Chambéry, , France

Site Status

Cabinet

Clapiers, , France

Site Status

Chu Clermont-Ferrand

Clermont-Ferrand, , France

Site Status

CHU Gabriel Montpied

Clermont-Ferrand, , France

Site Status

Cabinet

Dijon, , France

Site Status

Hôpital du bocage

Dijon, , France

Site Status

Cabinet

Échirolles, , France

Site Status

Cabinet

Genas, , France

Site Status

Cabinet

Grenoble, , France

Site Status

Chu Grenoble

Grenoble, , France

Site Status

Cabinet

Hennebont, , France

Site Status

Cabinet

Issy-les-Moulineaux, , France

Site Status

Ch La Rochelle

La Rochelle, , France

Site Status

Cabinet

Lille, , France

Site Status

Chru Lille

Lille, , France

Site Status

Hopital Saint Philibert

Lomme, , France

Site Status

CH Pierre-Bénite

Lyon, , France

Site Status

CH Mâcon

Mâcon, , France

Site Status

Cabinet

Montbonnot-Saint-Martin, , France

Site Status

Cabinet

Montélimar, , France

Site Status

Cabinet

Montigny-lès-Metz, , France

Site Status

Cabinet

Montluçon, , France

Site Status

Chu Montpellier

Montpellier, , France

Site Status

Chu Hotel Dieu

Nantes, , France

Site Status

CHR Orléans

Orléans, , France

Site Status

HEGP

Paris, , France

Site Status

Hôpital St Joseph

Paris, , France

Site Status

Cabinet

Péronne, , France

Site Status

Cabinet

Saint-Alban, , France

Site Status

Cabinet

Saint-Aubin-sur-Scie, , France

Site Status

Chu St Etienne

Saint-Etienne, , France

Site Status

Cabinet

Sélestat, , France

Site Status

Cabinet

Thonon-les-Bains, , France

Site Status

Chu Toulouse

Toulouse, , France

Site Status

Cabinet

Tournefeuille, , France

Site Status

Cabinet

Villeurbanne, , France

Site Status

Cabinet

Vizille, , France

Site Status

Countries

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France

References

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Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg. 2003 Jan;25(1):1-5. doi: 10.1053/ejvs.2002.1778.

Reference Type BACKGROUND
PMID: 12525804 (View on PubMed)

Oger E. Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost. 2000 May;83(5):657-60.

Reference Type BACKGROUND
PMID: 10823257 (View on PubMed)

Prandoni P, Kahn SR. Post-thrombotic syndrome: prevalence, prognostication and need for progress. Br J Haematol. 2009 May;145(3):286-95. doi: 10.1111/j.1365-2141.2009.07601.x. Epub 2009 Feb 13.

Reference Type BACKGROUND
PMID: 19222476 (View on PubMed)

Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S, Carta M, Cattelan AM, Polistena P, Bernardi E, Prins MH. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996 Jul 1;125(1):1-7. doi: 10.7326/0003-4819-125-1-199607010-00001.

Reference Type BACKGROUND
PMID: 8644983 (View on PubMed)

Prandoni P, Villalta S, Bagatella P, Rossi L, Marchiori A, Piccioli A, Bernardi E, Girolami B, Simioni P, Girolami A. The clinical course of deep-vein thrombosis. Prospective long-term follow-up of 528 symptomatic patients. Haematologica. 1997 Jul-Aug;82(4):423-8.

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PMID: 9299855 (View on PubMed)

Gabriel F, Labios M, Portoles O, Guillen M, Corella D, Frances F, Martinez M, Gil J, Saiz C. Incidence of post-thrombotic syndrome and its association with various risk factors in a cohort of Spanish patients after one year of follow-up following acute deep venous thrombosis. Thromb Haemost. 2004 Aug;92(2):328-36. doi: 10.1160/TH03-11-0700.

Reference Type BACKGROUND
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Kahn SR, Ginsberg JS. Relationship between deep venous thrombosis and the postthrombotic syndrome. Arch Intern Med. 2004 Jan 12;164(1):17-26. doi: 10.1001/archinte.164.1.17.

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PMID: 14718318 (View on PubMed)

Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med. 2002 May 27;162(10):1144-8. doi: 10.1001/archinte.162.10.1144.

Reference Type BACKGROUND
PMID: 12020185 (View on PubMed)

Bergqvist D, Jendteg S, Johansen L, Persson U, Odegaard K. Cost of long-term complications of deep venous thrombosis of the lower extremities: an analysis of a defined patient population in Sweden. Ann Intern Med. 1997 Mar 15;126(6):454-7. doi: 10.7326/0003-4819-126-6-199703150-00006.

Reference Type BACKGROUND
PMID: 9072931 (View on PubMed)

Brandjes DP, Buller HR, Heijboer H, Huisman MV, de Rijk M, Jagt H, ten Cate JW. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet. 1997 Mar 15;349(9054):759-62. doi: 10.1016/S0140-6736(96)12215-7.

Reference Type BACKGROUND
PMID: 9074574 (View on PubMed)

Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, Tormene D, Mosena L, Pagnan A, Girolami A. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med. 2004 Aug 17;141(4):249-56. doi: 10.7326/0003-4819-141-4-200408170-00004.

Reference Type BACKGROUND
PMID: 15313740 (View on PubMed)

Milne AA, Ruckley CV. The clinical course of patients following extensive deep venous thrombosis. Eur J Vasc Surg. 1994 Jan;8(1):56-9. doi: 10.1016/s0950-821x(05)80121-5.

Reference Type BACKGROUND
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Partsch H, Blattler W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg. 2000 Nov;32(5):861-9. doi: 10.1067/mva.2000.110352.

Reference Type BACKGROUND
PMID: 11054217 (View on PubMed)

Kahn SR, Elman E, Rodger MA, Wells PS. Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients. J Thromb Haemost. 2003 Mar;1(3):500-6. doi: 10.1046/j.1538-7836.2003.00098.x.

Reference Type BACKGROUND
PMID: 12871457 (View on PubMed)

Benko T, Cooke EA, McNally MA, Mollan RA. Graduated compression stockings: knee length or thigh length. Clin Orthop Relat Res. 2001 Feb;(383):197-203.

Reference Type BACKGROUND
PMID: 11210954 (View on PubMed)

Sajid MS, Tai NR, Goli G, Morris RW, Baker DM, Hamilton G. Knee versus thigh length graduated compression stockings for prevention of deep venous thrombosis: a systematic review. Eur J Vasc Endovasc Surg. 2006 Dec;32(6):730-6. doi: 10.1016/j.ejvs.2006.06.021. Epub 2006 Aug 23.

Reference Type BACKGROUND
PMID: 16931066 (View on PubMed)

Nelson EA, Harper DR, Prescott RJ, Gibson B, Brown D, Ruckley CV. Prevention of recurrence of venous ulceration: randomized controlled trial of class 2 and class 3 elastic compression. J Vasc Surg. 2006 Oct;44(4):803-8. doi: 10.1016/j.jvs.2006.05.051.

Reference Type BACKGROUND
PMID: 17012004 (View on PubMed)

Arpaia G, Cimminiello C, Mastrogiacomo O, de Gaudenzi E. Efficacy of elastic compression stockings used early or after resolution of the edema on recanalization after deep venous thrombosis: the COM.PRE Trial. Blood Coagul Fibrinolysis. 2007 Mar;18(2):131-7. doi: 10.1097/MBC.0b013e328011f2dd.

Reference Type BACKGROUND
PMID: 17287629 (View on PubMed)

Roumen-Klappe EM, den Heijer M, van Rossum J, Wollersheim H, van der Vleuten C, Thien T, Janssen MC. Multilayer compression bandaging in the acute phase of deep-vein thrombosis has no effect on the development of the post-thrombotic syndrome. J Thromb Thrombolysis. 2009 May;27(4):400-5. doi: 10.1007/s11239-008-0229-7. Epub 2008 May 15.

Reference Type BACKGROUND
PMID: 18480967 (View on PubMed)

Delluc A, Gouedard C, De Saint Martin L, Garcia C, Roguedas AM, Bressollette L, Misery L, Mottier D, Le Gal G. [Incidence, risk factors and skin manifestations of post-thrombotic syndrome: a four-year follow-up of patients included in the EDITH study]. Rev Med Interne. 2010 Nov;31(11):729-34. doi: 10.1016/j.revmed.2010.07.018. Epub 2010 Sep 29. French.

Reference Type BACKGROUND
PMID: 20880613 (View on PubMed)

Galanaud JP, Genty-Vermorel C, Barrellier MT, Becker F, Jabbour V, Blaise S, Bura-Riviere A, Comte A, Grange C, Guenneguez H, Maufus M, Ouvry P, Richaud C, Rolland C, Schmidt J, Sevestre MA, Verriere F, Bosson JL; CELEST trial investigators. 25 mm Hg versus 35 mm Hg elastic compression stockings to prevent post-thrombotic syndrome after deep vein thrombosis (CELEST): a randomised, double-blind, non-inferiority trial. Lancet Haematol. 2022 Dec;9(12):e886-e896. doi: 10.1016/S2352-3026(22)00247-2.

Reference Type DERIVED
PMID: 36455606 (View on PubMed)

Other Identifiers

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2010-A01078-31

Identifier Type: OTHER

Identifier Source: secondary_id

CVE301-10 (Themas) : DCIC/1028

Identifier Type: -

Identifier Source: org_study_id

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